Cleft care in Nigeria: past, present, and future

To review the progress of orofacial cleft care in Nigeria and propose a viewpoint for the future.

Review of the available literature on cleft care in Nigeria and survey of the status of ongoing cleft care in Nigerian centers. We employed a pretested self-administered questionnaire sent and returned through electronic mail.

Coordinators of cleft care centers in Nigeria.

Findings of literature search and responses to mailed questionnaires.

Available literature suggests that the fate of orofacial cleft patients during the precolonial era in Nigeria remains unclear. However, there is evidence of surgical care delivery just before the end of the colonial era. We identified and contacted 39 existing cleft care delivery centers, of which 30 (76.9%) responded. The majority (69.2%) of the responding centers began cleft care delivery between 2006 and 2010; 73.3% have designated cleft clinic locations and 66.7% offer interdisciplinary care. All responding centers offer cheiloplasty, while 86.7% offer palatoplasty. Other aspects of cleft care are provided sparingly in most centers due to paucity of manpower. Challenges with hospital administration, securing bed and theater spaces, drug availability, and performing laboratory investigations were the common limitations reported.

We advocate for improved cleft care delivery through removing administrative bottlenecks, fortifying existing centers, and mentoring younger colleagues for entry into underserved specialties. Concerted effort and international collaborations aimed at transforming some of the existing cleft centers to standard pediatric craniofacial centers are desirable.